This comprehensive Center grant application (P60), submitted in response to RFA MD-06-002, "Project EXPORT," will promote high quality, culturally competent, theoretically sound, and programmatically relevant research through projects that promise to shed important light on the barriers and facilitators to improved health status and functioning of American Indians and Alaska Natives (AI/ANs). Our renewal of an explicitly focused center is a consortium of 2 institutions that have a long and successful track record of working together collaboratively and synergistically: the American Indian and Alaska Native Programs at the University of Colorado at Denver and Health Sciences Center and the University of Washington. Of equal importance is the larger network of organizations and institutions serving AI/AN populations that will increase both the extent of, as well as the subsequent capacity for research undertaken by AI/ANs and focused on a racial minority suffering from striking health disparities. Towards these ends, the Specific Aims are to 1) provide an administrative structure that promotes excellence in research and research capacity-building specific to improving the health and well-being of AI/ANs, 2) plan and carry out an interdisciplinary, culturally grounded, problem-oriented research program of major scientific and programmatic importance to the health status and functioning of AI/ANs, 3) structure and pursue career development opportunities for AI/AN investigators through an existing, highly successful, intensive mentorship program, 4) disseminate the results of this work to guide the design, conduct, and interpretation of future research specific to understanding and reducing the health disparities that plague AI/AN communities, and 5) assist individuals, provider organizations, and other institutions of higher education in planning and implementing similar health research and in maximizing the relevance of its outcomes for application in AI/AN communities. This Project EXPORT will emphasize new projects that will lead to understanding and improving the a) detection and management of depression in primary care, b) contribution of traditional healing practices to reduced risk of diabetes and cardiovascular disease, c) availability of Medicaid insurance on patient outcomes and survival among cancer patients, d) built environment in increasing physical activity levels and select metabolic health outcomes, e) early psychosocial interventions for injury survivors at high risk of posttraumatic stress disorder, f) evidence based follow up of cancer survivors by tribal health care providers, g) elevated risk of chronic liver disease, h) communication of risk information on renal disease to patients with type 2 diabetics, i) implicit racial biases and stereotypes of primary care providers, and j) oral health prevention for young children. This renewal application builds on our work by pursuing unexpected insights emerging from current projects, by involving former AI/AN mentees as investigators, by enhancing an innovative outreach and dissemination program, by broadening institutional and tribal collaborations, and by attracting new investigators to our agenda.